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Affaitati G, Costantini R, Fiordaliso M, Giamberardino MA, Tana C. Pain from Internal Organs and Headache: The Challenge of Comorbidity. Diagnostics (Basel) 2024; 14:1750. [PMID: 39202238 PMCID: PMC11354044 DOI: 10.3390/diagnostics14161750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 07/24/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024] Open
Abstract
Headache and visceral pain are common clinical painful conditions, which often co-exist in the same patients. Numbers relative to their co-occurrence suggest possible common pathophysiological mechanisms. The aim of the present narrative review is to describe the most frequent headache and visceral pain associations and to discuss the possible underlying mechanisms of the associations and their diagnostic and therapeutic implications based on the most recent evidence from the international literature. The conditions addressed are as follows: visceral pain from the cardiovascular, gastrointestinal, and urogenital areas and primary headache conditions such as migraine and tension-type headache. The most frequent comorbidities involve the following: cardiac ischemic pain and migraine (possible shared mechanism of endothelial dysfunction, oxidative stress, and genetic and hormonal factors), functional gastrointestinal disorders, particularly IBS and both migraine and tension-type headache, primary or secondary dysmenorrhea and migraine, and painful bladder syndrome and headache (possible shared mechanisms of peripheral and central sensitization processes). The data also show that the various visceral pain-headache associations are characterized by more than a simple sum of symptoms from each condition but often involve complex interactions with the frequent enhancement of symptoms from both, which is crucial for diagnostic and treatment purposes.
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Affiliation(s)
- Giannapia Affaitati
- Department of Innovative Technologies in Medicine and Dentistry, Center for Advanced Studies and Technology (CAST), G. D’Annunzio University of Chieti, 66100 Chieti, Italy;
| | | | - Michele Fiordaliso
- Department of Medicine and Ageing Sciences, G D’Annunzio University of Chieti, 66100 Chieti, Italy;
| | - Maria Adele Giamberardino
- Headache Center, Geriatrics Clinic, Department of Medicine and Science of Aging, Center for Advanced Studies and Technology (CAST), G. D’Annunzio University of Chieti, 66100 Chieti, Italy;
| | - Claudio Tana
- Headache Center, Geriatrics Clinic, SS Annunziata Hospital, 66100 Chieti, Italy
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Tian X, Wei J, Zhuang Y, Lin X, Liu L, Xia J, Huai W, Xiong Y, Chen Y. Effectiveness and safety of Chinese herbal footbaths as an adjuvant therapy for dysmenorrhea: a systematic review and meta-analysis. Front Pharmacol 2024; 15:1397359. [PMID: 39161905 PMCID: PMC11331266 DOI: 10.3389/fphar.2024.1397359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 07/16/2024] [Indexed: 08/21/2024] Open
Abstract
Objectives To evaluate the effectiveness and safety of Chinese herbal footbaths (CHF) as an adjunctive therapy in managing dysmenorrhea. Methods Ten electronic databases were searched to identify eligible randomized clinical trials (RCTs) from inception until June 2023. Outcome measurements encompassed the total effective rate, visual analog scale (VAS) score of pain intensity, Cox menstrual symptom scale (CMSS) score, symptom score, Traditional Chinese Medicine (TCM) syndrome scale, and any reported adverse events. The methodological quality of the included studies was assessed with the Cochrane collaboration tool. Review Manager 5.3 software was employed for quantitative synthesis, and funnel plots were utilized to evaluate potential reporting bias. Results Eighteen RCTs with 1,484 dysmenorrhea patients were included. The aggregated results suggested that the adjunctive CHF could significantly ameliorate dysmenorrhea, as evident from the improved total effective rate [risk ratio (RR) 1.18, 95% confidence interval (CI): 1.12 to 1.23, P < 0.00001], VAS (MD 0.88, 95% CI: 0.68 to 1.09, P < 0.00001), CMSS (MD 3.61, 95% CI: 2.73 to 4.49, P < 0.00001), symptom score (SMD 1.09, 95% CI: 0.64 to 1.53, P < 0.00001), and TCM syndrome scale (MD 3.76, 95% CI: 2.53 to 4.99, P < 0.0001). In addition, CHF presented fewer adverse events with a better long-term effect (RR 1.34, 95% CI: 1.11 to 1.63, P < 0.01) and diminished recurrence rate (RR 0.19, 95% CI: 0.09 to 0.39, P < 0.0001). Conclusion Current evidence implies that CHF may be an effective and safe adjunctive therapy for patients with dysmenorrhea. However, the methodological quality of the studies included was undesirable, necessitating further verification with more well-designed and high-quality multicenter RCTs. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=188256, identifier registration number.
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Affiliation(s)
- Xiaoping Tian
- CDUTCM-KEELE Health and Medical Sciences Institute, School of Basic Medical Sciences, School of Acupuncture, Moxibustion, and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jingwen Wei
- West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Yijia Zhuang
- West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Xiaoding Lin
- CDUTCM-KEELE Health and Medical Sciences Institute, School of Basic Medical Sciences, School of Acupuncture, Moxibustion, and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liu Liu
- CDUTCM-KEELE Health and Medical Sciences Institute, School of Basic Medical Sciences, School of Acupuncture, Moxibustion, and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jun Xia
- CDUTCM-KEELE Health and Medical Sciences Institute, School of Basic Medical Sciences, School of Acupuncture, Moxibustion, and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wenying Huai
- CDUTCM-KEELE Health and Medical Sciences Institute, School of Basic Medical Sciences, School of Acupuncture, Moxibustion, and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ying Xiong
- West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Yunhui Chen
- CDUTCM-KEELE Health and Medical Sciences Institute, School of Basic Medical Sciences, School of Acupuncture, Moxibustion, and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Vargas-Costales JA, Rosero CYDLMV, Mazin SC, Candido-Dos-Reis FJ, Nogueira AA, Rosa-E-Silva JC, Poli-Neto OB. Prevalence of chronic pelvic pain and associated factors among indigenous women of reproductive age in Ecuador. BMC Womens Health 2024; 24:388. [PMID: 38965526 PMCID: PMC11223279 DOI: 10.1186/s12905-024-03189-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 06/07/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Chronic pelvic pain is a common disease that affects approximately 4% of women of reproductive age in developed countries. This number is estimated to be higher in developing countries, with a significant negative personal and socioeconomic impact on women. The lack of data on this condition in several countries, particularly those in development and in socially and biologically vulnerable populations such as the indigenous, makes it difficult to guide public policies. OBJECTIVES To evaluate the prevalence of chronic pelvic pain (dysmenorrhea, dyspareunia, non-cyclical pain) and identify which variables are independently associated with the presence of the condition in indigenous women from Otavalo-Ecuador. DESIGN A cross-sectional study was carried out including a sample of 2429 women of reproductive age between 14 and 49 years old, obtained from April 2022 to March 2023. A directed questionnaire was used, collected by bilingual interviewers (Kichwa and Spanish) belonging to the community itself; the number of patients was selected by random sampling proportional to the number of women estimated by sample calculation. Data are presented as case prevalence, odds ratio, and 95% confidence interval, with p < 0.05. RESULTS The prevalence of primary dysmenorrhea, non-cyclic pelvic pain, and dyspareunia was, respectively, 26.6%, 8.9%, and 3.9%.all forms of chronic pain were independently associated with each other. Additionally, dysmenorrhoea was independently associated with hypertension, intestinal symptoms, miscegenation, long cycles, previous pregnancy, use of contraceptives and pear body shape. Pain in other sites, late menarche, exercise, and pear body shape were associated with non-cyclic pelvic pain. And, urinary symptoms, previous pregnancy loss, miscegenation, and pear body shape were associated with dyspareunia. CONCLUSION The prevalence of primary dysmenorrhea and non-cyclical chronic pelvic pain was notably high, in contrast with the frequency of reported dyspareunia. Briefly, our results suggest an association between dysmenorrhoea and conditions related to inflammatory and/or systemic metabolic disorders, including a potential causal relationship with other manifestations of pelvic pain, and between non-cyclical pelvic pain and signs/symptoms suggesting central sensitization. The report of dyspareunia may be influenced by local cultural values and beliefs.
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Affiliation(s)
- José Antonio Vargas-Costales
- Department of Pharmacology, School of Medicine, Faculty of Medical Sciences, Central University of Ecuador, Quito, Ecuador
| | | | - Suleimy Cristina Mazin
- Department of Obstetrics and Gynecology, Laboratory for Translational Data Science, Ribeirão Preto Medical School of the University of São Paulo USP, Bandeirantes Avenue. Monte Alegre. Ribeirão Preto, Ribeirão Preto, SP, 3900, 049-900, Brazil
| | - Francisco José Candido-Dos-Reis
- Department of Obstetrics and Gynecology, Laboratory for Translational Data Science, Ribeirão Preto Medical School of the University of São Paulo USP, Bandeirantes Avenue. Monte Alegre. Ribeirão Preto, Ribeirão Preto, SP, 3900, 049-900, Brazil
- Laboratory for Translational Data Science, CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico), Brasília, Brazil
| | - Antonio Alberto Nogueira
- Department of Obstetrics and Gynecology, Laboratory for Translational Data Science, Ribeirão Preto Medical School of the University of São Paulo USP, Bandeirantes Avenue. Monte Alegre. Ribeirão Preto, Ribeirão Preto, SP, 3900, 049-900, Brazil
| | - Julio Cesar Rosa-E-Silva
- Department of Obstetrics and Gynecology, Laboratory for Translational Data Science, Ribeirão Preto Medical School of the University of São Paulo USP, Bandeirantes Avenue. Monte Alegre. Ribeirão Preto, Ribeirão Preto, SP, 3900, 049-900, Brazil
- Laboratory for Translational Data Science, CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico), Brasília, Brazil
| | - Omero Benedicto Poli-Neto
- Department of Obstetrics and Gynecology, Laboratory for Translational Data Science, Ribeirão Preto Medical School of the University of São Paulo USP, Bandeirantes Avenue. Monte Alegre. Ribeirão Preto, Ribeirão Preto, SP, 3900, 049-900, Brazil.
- Laboratory for Translational Data Science, CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico), Brasília, Brazil.
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Srinivasa Gopalan S, Mann C, Rhodes RE. Impact of symptoms, experiences, and perceptions of the menstrual cycle on recreational physical activity of cyclically menstruating individuals: A systematic review. Prev Med 2024; 184:107980. [PMID: 38704099 DOI: 10.1016/j.ypmed.2024.107980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/13/2024] [Accepted: 04/30/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVE The menstrual cycle often presents barriers to participation in daily life activities, including physical activity (PA), which is a cornerstone of health and well-being. The purpose of this systematic review was to explore and summarize the impact of symptoms, experiences, and perceptions of the menstrual cycle on recreational PA (RPA), including sports, exercise and active recreation, in the general population. METHODS Six databases were searched for studies that investigated the impact of the menstrual cycle on PA among individuals who were cyclically menstruating, healthy, and not involved in professional sports training. RESULTS The search yielded 3025 studies that were screened for relevance and eligibility, resulting in 25 eligible studies, which were found to be of moderate-to-high quality following a quality and risk-of-bias assessment. Thematic synthesis of qualitative and quantitative data from the selected studies, constituting 16,557 adults and 3715 adolescents, identified the impact of menstrual symptoms on the physical and psychological capability to participate in RPA, social opportunity barriers to RPA (e.g., social pressure due to the sociocultural taboo against menstruation), as well reflective (knowledge) and automatic (habit) motivation on RPA behaviours. CONCLUSION The variability in menstrual symptoms and corresponding experiences suggested the need for an individualized approach to RPA promotion. Furthermore, this review highlighted the need to address the sociocultural taboo against menstruation, as well as improve the provision of knowledge and resources related to the menstrual cycle and RPA, in order to promote and facilitate RPA for cyclically menstruating individuals throughout the menstrual cycle.
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Affiliation(s)
- Sharan Srinivasa Gopalan
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada.
| | - Caitlin Mann
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
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Wang L, Li T, Cao WX, Zhao JY, Xu XH, Chai JP, Zhang JX, Liu J, Wang FC. To explore the mechanism of acupoint application in the treatment of primary dysmenorrhea by 16S rDNA sequencing and metabolomics. Front Endocrinol (Lausanne) 2024; 15:1397402. [PMID: 38872962 PMCID: PMC11169635 DOI: 10.3389/fendo.2024.1397402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/16/2024] [Indexed: 06/15/2024] Open
Abstract
Graphene-based warm uterus acupoint paste (GWUAP) is an emerging non-drug alternative therapy for the treatment of primary dysmenorrhea (PD), but the underlying mechanism is still unclear. SD female rats were randomly divided into control group, model group and treatment group to explore the mechanism of GWUAP in the treatment of PD. Combined with 16S rDNA and fecal metabolomics, the diversity of microbiota and metabolites in each group was comprehensively evaluated. In this study, GWUAP reduced the torsion score of PD model rats, improved the pathological morphology of uterine tissue, reduced the pathological damage score of uterine tissue, and reversed the expression levels of inflammatory factors, pain factors and sex hormones. The 16 S rDNA sequencing of fecal samples showed that the abundance of Lactobacillus in the intestinal flora of the model group decreased and the abundance of Romboutsia increased, while the abundance of Lactobacillus in the intestinal flora of the treatment group increased and the abundance of Romboutsia decreased, which improved the imbalance of flora diversity in PD rats. In addition, 32 metabolites related to therapeutic effects were identified by metabolomics of fecal samples. Moreover, there is a close correlation between fecal microbiota and metabolites. Therefore, the mechanism of GWUAP in the treatment of PD remains to be further studied.
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Affiliation(s)
- Lin Wang
- Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Tie Li
- Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Wen-Xuan Cao
- Department of Pharmacy, Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Jin-Ying Zhao
- Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Xiao-Hong Xu
- Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Jia-Peng Chai
- Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Jia-Xun Zhang
- Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Jia Liu
- Department of Pharmacy, Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Fu-Chun Wang
- Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, China
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Li X, Sun Y, Wang Y, Wang X, Yu C. Manual Therapy in Primary Dysmenorrhea: A Systematic Review and Meta-Analysis. J Pain Res 2024; 17:1663-1681. [PMID: 38736680 PMCID: PMC11088071 DOI: 10.2147/jpr.s457381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/19/2024] [Indexed: 05/14/2024] Open
Abstract
Objective This research aimed to assess the effectiveness of manual therapy in alleviating pain among women undergoing primary dysmenorrhea (PD). Methods All randomized controlled trials (RCTs) regarding manual therapy for PD were searched from online databases, spanning from their inception to July 2023. The identified literature underwent a thorough screening process, and the data were meticulously extracted and analyzed using RevMan 5.3. Subsequently, the included studies underwent Cochrane's quality assessment and meta-analysis. The evidence obtained was then assessed using the grading of recommendations, assessment, development, and evaluation (GRADE) approach. Results 32 RCTs, involving 2566 women were finally included for analysis. The overall quality of the concluding evidence was generally rated as low or very low. Performance bias and blind bias were found to be the main risk of bias of the included studies. In comparison to no treatment, manual therapy demonstrated a significant increase in pain relief in short-term (n=191, MD=1.30, 95% CI: 0.24~2.37). The differences in the effects of manual therapy and the placebo on pain intensity may not be statistically significant (n=255, MD=0.10, 95% CI: -0.37~0.58). In contrast to NSAIDs, manual therapy exhibited superior pain alleviation (n=507, MD=3.01, 95% CI: 1.08~4.94) and a higher effective rate (n=1029, OR=4.87, 95% CI: 3.29~7.20). Importantly, no severe adverse events were reported across all studies, indicating a relatively safe profile for manual therapy. Conclusion Manual therapy presented promise in effectively relieving menstrual pain with minimal adverse events in short term, outperforming both no treatment and NSAIDs. However, this conclusion is tempered by the low quality of the included RCTs, highlighting the necessity for more robust trials to validate it.
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Affiliation(s)
- Xia Li
- Tuina and Pain Management Department, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, People’s Republic of China
| | - Yanan Sun
- Traditional Chinese Medicine Department, Xuanwu Hospital Capital Medical University, Beijing, People’s Republic of China
| | - Yuhan Wang
- Tuina and Pain Management Department, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, People’s Republic of China
| | - Xiyou Wang
- Tuina and Pain Management Department, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, People’s Republic of China
| | - Changhe Yu
- Tuina and Pain Management Department, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, People’s Republic of China
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Lin KC, Huang KJ, Lin MN, Wang CY, Tsai TY. Vitamin D Supplementation for Patients with Dysmenorrhoea: A Meta-Analysis with Trial Sequential Analysis of Randomised Controlled Trials. Nutrients 2024; 16:1089. [PMID: 38613122 PMCID: PMC11013696 DOI: 10.3390/nu16071089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/01/2024] [Accepted: 04/07/2024] [Indexed: 04/14/2024] Open
Abstract
Vitamin D reduces prostaglandin levels and inflammation, making it a promising treatment option for dysmenorrhoea. However, its effects on pain intensity in different types of dysmenorrhoea remain unclear. We examined whether vitamin D supplementation decreases pain intensity in patients with dysmenorrhoea. The Cochrane Library, Embase, Google Scholar, Medline, and Scopus databases were searched from inception to 30 December 2023. Randomised controlled trials (RCTs) evaluating vitamin D supplementation effects on such patients were included. The primary and secondary outcomes were measured by the changes in pain intensity and rescue analgesic use, respectively. Pooled mean differences and rate ratios were calculated using a random-effect model; trial sequential analysis (TSA) was also performed. Overall, 11 studies involving 687 participants were included. Vitamin D supplementation significantly decreased pain intensity in patients with dysmenorrhoea compared with controls (pooled mean difference, -1.64; 95% confidence interval, -2.27 to -1.00; p < 0.001; CoE, moderate; I2 statistic, 79.43%) and indicated substantial heterogeneity among the included studies. TSA revealed that the current RCTs provide sufficient information. In subgroup analyses, vitamin D supplement reduced primary dysmenorrhoea pain but not secondary dysmenorrhoea pain. In conclusion, although substantial heterogeneity persists, vitamin D supplementation decreased pain intensity in patients with dysmenorrhea, especially in those with primary dysmenorrhoea.
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Affiliation(s)
- Kan-Chu Lin
- Family Medicine Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan; (K.-C.L.); (M.-N.L.)
| | - Kuan-Ju Huang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital Yunlin Branch, Yunlin 640203, Taiwan;
| | - Ming-Nan Lin
- Family Medicine Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan; (K.-C.L.); (M.-N.L.)
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
| | - Cheng-Yu Wang
- Family Medicine Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan; (K.-C.L.); (M.-N.L.)
| | - Tou-Yuan Tsai
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
- Emergency Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 106319, Taiwan
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Qu M, Lu P, Lifshitz LM, Moore Simas TA, Delpapa E, ZhuGe R. Phenanthroline relaxes uterine contractions induced by diverse contractile agents by decreasing cytosolic calcium concentration. Eur J Pharmacol 2024; 968:176343. [PMID: 38281680 PMCID: PMC10939717 DOI: 10.1016/j.ejphar.2024.176343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 01/17/2024] [Accepted: 01/17/2024] [Indexed: 01/30/2024]
Abstract
Uterine contractions during labor and preterm labor are influenced by a complex interplay of factors, including hormones and inflammatory mediators. This complexity may contribute to the limited efficacy of current tocolytics for preterm labor, a significant challenge in obstetrics with 15 million cases annually and approximately 1 million resulting deaths worldwide. We have previously shown that the myometrium expresses bitter taste receptors (TAS2Rs) and that their activation leads to uterine relaxation. Here, we investigated whether the selective TAS2R5 agonist phenanthroline can induce relaxation across a spectrum of human uterine contractions and whether the underlying mechanism involves changes in intracellular Ca2+ signaling. We performed experiments using samples from pregnant women undergoing scheduled cesarean delivery, assessing responses to various inflammatory mediators and oxytocin with and without phenanthroline. Our results showed that phenanthroline concentration-dependently inhibited contractions induced by PGF2α, U46619, 5-HT, endothelin-1 and oxytocin. Furthermore, in hTERT-infected human myometrial cells exposed to uterotonics, phenanthroline effectively suppressed the increase in intracellular Ca2+ concentration induced by PGF2α, U46619, oxytocin, and endothelin-1. These results suggest that the selective TAS2R5 agonist may not only significantly reduce uterine contractions but also decrease intracellular Ca2+ levels. This study highlights the potential development of TAS2R5 agonists as a new class of uterine relaxants, providing a novel avenue for improving the management of preterm labor.
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Affiliation(s)
- Mingzi Qu
- Department of Microbiology and Physiological Systems, UMass Chan Medical School, 363 Plantation St., Worcester, MA, USA
| | - Ping Lu
- Department of Microbiology and Physiological Systems, UMass Chan Medical School, 363 Plantation St., Worcester, MA, USA
| | - Lawrence M Lifshitz
- Program in Molecular Medicine, UMass Chan Medical School, 373 Plantation St., Worcester, MA, USA
| | - Tiffany A Moore Simas
- Department of Obstetrics and Gynecology, UMass Chan Medical School/UMass Memorial Health, 119 Belmont St, Worcester, MA, USA
| | - Ellen Delpapa
- Department of Obstetrics and Gynecology, UMass Chan Medical School/UMass Memorial Health, 119 Belmont St, Worcester, MA, USA.
| | - Ronghua ZhuGe
- Department of Microbiology and Physiological Systems, UMass Chan Medical School, 363 Plantation St., Worcester, MA, USA.
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Triwahyuningsih RY, Rahfiludin MZ, Sulistiyani S, Widjanarko B. Role of stress and physical activity on primary dysmenorrhea: A cross-sectional study. NARRA J 2024; 4:e685. [PMID: 38798864 PMCID: PMC11125384 DOI: 10.52225/narra.v4i1.685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/29/2024] [Indexed: 05/29/2024]
Abstract
The initial physiological change in adolescent girls is the onset of menstruation. The most prevalent challenge they face regarding menstruation is primary dysmenorrhea, characterized by persistent or intermittent pelvic pain in the lower abdomen. The aim of this study was to investigate the influences of stress levels and physical activities on primary dysmenorrhea. A cross-sectional was conducted in Cirebon, Indonesia, in 2023 included young women who had never given birth (nullipara), aged 17-25 years old, had menstruated, and had no history of smoking and alcohol. The data were collected using a set of questionnaires consisting of the Numeric Rating Scale (NRS) to determine primary dysmenorrhea pain, the Depression Anxiety Stress Scales 42 (DASS 42) to determine the level of stress and the International Physical Activity Questionnaire (IPAQ) to determine physical activity. Pearson's correlation test was used to assess the correlation between the variables (stress levels, physical activity, and dysmenorrhea). A total of 150 young women were included in the study. Moderate stress levels (23.3%) and high physical activity (90.7%) were the most prevalent category observed among studied participants. Approximately 42% of them experienced mild dysmenorrhea pain. Our analysis indicated that stress levels and physical activities had strong positive and negative correlations with dysmenorrhea pain levels, with r=0.782 and r=-0.748, respectively, with both had p<0.001. This highlights that controlling stress could be beneficial in preventing dysmenorrhea pain among young women.
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Affiliation(s)
- Ria Y. Triwahyuningsih
- Department of Public Health, Faculty of Public Health, Universitas Diponegoro, Semarang, Indonesia
| | - M. Zen Rahfiludin
- Department of Nutrition, Faculty of Public Health, Universitas Diponegoro, Semarang, Indonesia
| | - Sulistiyani Sulistiyani
- Environmental Health Department, Faculty of Public Health, Universitas Diponegoro, Semarang, Indonesia
| | - Bagoes Widjanarko
- Health Education and Behavioral Sciences, Faculty of Public Health, Universitas Diponegoro, Semarang, Indonesia
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Matheson SC, Durand H. Help-seeking behaviour in dysmenorrhoea: A cross-sectional exploration using the Behavioural Model of Health Services Use. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241273588. [PMID: 39165006 PMCID: PMC11339737 DOI: 10.1177/17455057241273588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 07/14/2024] [Accepted: 07/16/2024] [Indexed: 08/22/2024]
Abstract
BACKGROUND Dysmenorrhoea, or period pain, is a prevalent gynaecological condition that can result in functional interference during menstruation. Despite the significant disruption dysmenorrhoea can have on functioning and well-being, medical help-seeking rates are low. Little is known about what factors may predict help-seeking for dysmenorrhoea. OBJECTIVES The current study aimed to test the predictive validity of the Behavioural Model of Health Services Use (BMHSU) for help-seeking behaviour in dysmenorrhoea, whereby help-seeking behaviour was operationalised as having attended to a healthcare professional for dysmenorrhoea-related care. DESIGN A cross-sectional observational design was used. METHODS Participants (N = 439) completed an online survey, which measured the following eight predictor variables: menstrual pain characteristics, health beliefs, self-efficacy, social support utilisation and satisfaction, perceived healthcare availability, and pain intensity and interference. Participants were also asked to report whether they had ever attended to a healthcare professional for their menstrual pain. RESULTS The BMHSU accounted for 8% of the variance in help-seeking behaviour. Pain interference and appointment availability were significant predictors of the variance in past help-seeking behaviour, such that those who experienced greater pain interference, and those who perceived greater availability of healthcare appointments were less likely to have visited a healthcare professional for their menstrual pain. The BMHSU had an overall 69% classification accuracy in predicting help-seeking behaviour. CONCLUSION Although the BMHSU demonstrated reasonably good model fit, it does not appear to be a particularly robust model for predicting help-seeking behaviour for dysmenorrhoea. Future research should explore whether a refined BMHSU or an alternative theoretical model can provide more useful insight into this behaviour. Better understanding of the determinants of help-seeking behaviour will enable the development of interventions to promote appropriate help-seeking and improve health outcomes for individuals with menstrual pain.
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Affiliation(s)
- Sophie C Matheson
- Division of Psychology, University of Stirling, Stirling, Scotland, UK
| | - Hannah Durand
- Division of Psychology, University of Stirling, Stirling, Scotland, UK
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Ciołek A, Kostecka M, Kostecka J, Kawecka P, Popik-Samborska M. An Assessment of Women's Knowledge of the Menstrual Cycle and the Influence of Diet and Adherence to Dietary Patterns on the Alleviation or Exacerbation of Menstrual Distress. Nutrients 2023; 16:69. [PMID: 38201899 PMCID: PMC10780571 DOI: 10.3390/nu16010069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
A growing number of women of reproductive age experience menstrual disorders. The menstrual cycle is considerably influenced by dietary habits, physical activity, and the use of stimulants. The main aim of this study was to assess women's knowledge about the menstrual cycle and the influence of diet and lifestyle factors on menstrual symptoms, and to identify dietary models that may alleviate or exacerbate menstrual distress. A total of 505 young women participated in the study. Nearly 90% of the respondents reported at least one menstrual disorder, mostly dysmenorrhea (70.7%), whereas secondary amenorrhea was least frequently reported (13.8%) (p = 0.002). In the study population, dysmenorrhea/menstrual distress was linked with higher consumption frequency of certain food groups. Women with severe dysmenorrhea consumed refined cereal products, processed meat, sugar, and water significantly more frequently than women with moderate menstrual pain. In turn, sweetened dairy products, animal fats, and fruit were consumed more frequently by women with low intensity of menstrual pain (mild pain). Significant differences in knowledge about the menstrual cycle and physiological changes in the body were observed between the compared dietary models.
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Affiliation(s)
- Anna Ciołek
- Department of Chemistry, Faculty of Food Science and Biotechnology, University of Life Sciences, Akademicka 15, 20-950 Lublin, Poland; (A.C.); (P.K.)
| | - Malgorzata Kostecka
- Department of Chemistry, Faculty of Food Science and Biotechnology, University of Life Sciences, Akademicka 15, 20-950 Lublin, Poland; (A.C.); (P.K.)
| | - Julianna Kostecka
- Faculty of Medicine, Medical University of Lublin, Chodźki 19, 20-093 Lublin, Poland;
| | - Paulina Kawecka
- Department of Chemistry, Faculty of Food Science and Biotechnology, University of Life Sciences, Akademicka 15, 20-950 Lublin, Poland; (A.C.); (P.K.)
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Kovács Z, Hegyi G, Szőke H. The Effect of Exercise on Pulsatility Index of Uterine Arteries and Pain in Primary Dysmenorrhea. J Clin Med 2023; 12:7021. [PMID: 38002635 PMCID: PMC10671949 DOI: 10.3390/jcm12227021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/14/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Primary dysmenorrhea (PD) is one of the most common diseases in women of reproductive age. Our aim was to examine whether a twice-weekly thirty-minute exercise intervention could result in a difference in the pulsatility index (PI) of the uterine arteries (UAs) and level of menstrual pain in patients with PD. METHODS In our prospective observational trial, the observation period included one spontaneous menstrual cycle and the consecutive time of the next menstruation of all participants, aged 18-44, with no extensive sports experience. In total, 73 volunteers were enrolled: 38 persons in the intervention group (IG) and 35 in the control group (CG). The intervention program was accompanied by music, performed in groups under the supervision of a qualified instructor in Hungary. The primary outcome was the difference between the IG and CG regarding the PI values of UAs at the 1st and the 2nd ultrasound (US) Doppler flowmetry. The secondary outcome was the difference between the IG and CG regarding the PI of UAs and menstrual pain measured by using the Numeric Rating Scale and adherence to the intervention. Statistical tests such as an independent-samples t-test, chi-square test, Mann-Whitney test and analysis of covariance (ANCOVA) were used during the analyses. RESULTS Examining the mean of the PI of UAs in the IG and the CG at the 1st and the 2nd US measurement, a significant difference was found in the change in the measured value (Z = -2.545; p = 0.011). The IG showed a significantly higher increase in the mean of the PI of UAs (Median = 0.825) than the CG (Median = 0.130). The difference in the PI of the UAs of the IG and the CG is not related to the level of pain in any group (p = 0.336) and not related to the whole sample (p = 0.354); furthermore, the level of pain did not significantly differ between the two groups. CONCLUSIONS Our study is the first to document the significant effects of mild-to-moderate exercise training on the change in the PI of the UAs in individuals with PD. The IG had a reduced blood flow due to circulatory redistribution after exercise. The level of menstrual pain of primary dysmenorrhea patients is independent of the level of blood circulation regarding the PI of the UAs. Randomized controlled studies with more participants and a longer research period are needed to confirm our findings regarding the association between regular exercise and the PI of UAs. The study was registered at clinicaltrials.gov: NCT04618172.
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Affiliation(s)
- Zoltán Kovács
- Department of Obstetrics, Robert Hospital, 1135 Budapest, Hungary
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (G.H.); (H.S.)
| | - Gabriella Hegyi
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (G.H.); (H.S.)
| | - Henrik Szőke
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (G.H.); (H.S.)
- Department of Integrative Medicine, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary
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